Provider Demographics
NPI:1508110784
Name:SALEH REYES, SAMIR H (PHARMD)
Entity Type:Individual
Prefix:
First Name:SAMIR
Middle Name:H
Last Name:SALEH REYES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9310 SOUTHPARK CENTER LOOP
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8634
Mailing Address - Country:US
Mailing Address - Phone:866-249-1556
Mailing Address - Fax:407-845-6799
Practice Address - Street 1:9310 SOUTHPARK CENTER LOOP
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:866-249-1556
Practice Address - Fax:407-845-6799
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist